In 68 patients (mean age 71 ± 8 years) with clinically diagnosed Alzheimer's disease (AD), the presence of various neurologic motor signs was investigated, both in the total patient sample and in subgroups with early-onset AD (onset before 65 years of age; n = 30) and late-onset AD (onset at the age of 65 years or later; n = 38). Each type of basic neurologic motor sign in the total patient sample was related to basic clinical variables, brain regional symptomatology, and white-matter lesions and atrophy visualized by computerized tomography. Bipyramidal, extrapyramidal, and pseudobulbar signs were present in 21, 22 and 7%, respectively, of the total patient sample. Extrapyramidal, but not bipyramidal, signs were significantly related to the degree of dementia (p < 0.05), while pseudobulbar signs were significantly related to the presence of white-matter lesions on computerized tomography (p < 0.001). Bipyramidal signs were significantly more frequent in early-onset (37%) than in late-onset (8%) AD (p < 0.01), while extrapyramidal signs appeared in 17% of early-onset compared with 26% of late-onset AD patients. The difference in the frequency of bipyramidal signs is in line with previous findings of biological differences between early- and late-onset AD patients. Extrapyramidal signs, however, are more likely to be end-point manifestations of a disease process than indicators of an early-late-onset dichotomy. Pseudobulbar signs in AD may be indicators of white-matter lesions.

Keywords:
Alzheimer's disease, Dementia, Clinical examination, Neurologic examination, Neuropsychiatric examination, Computerized tomography
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© 1992 S. Karger AG, Basel
1992
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